ABSTRACT
Neuropathic pain is one of the most difficult conditions to treat in clinical neurological practice. Central pain is defined as pain initiated or caused by a primary lesion or dysfunction in the central nervous system (CNS). Some of the early work in this area was performed by Penfield and Jasper in the 1950s. During their surgeries on patients with epilepsy, they observed that stimulation of the precentral gyrus elicited sensory responses when the corresponding portion of the adjacent postcentral gyrus was resected. Their extensive mapping and study of the sensory and motor cortex laid the foundation for the understanding that both the pre-and postcentral gyri are involved in pain. In the 1970s, electrical stimulation with bipolar current, targeted in or near the internal capsule, was found to have a positive effect on centrally mediated pain, establishing the concept that thalamic involvement was a key mediator in central pain.
